Importância do Lúdico no Impacto Psicológico da Hospitalização Infantil Estudo no Hospital Regional Santiago Norte

O presente trabalho de investigação propõe estudar a “Importância do Lúdico no Impacto Psicológico da Hospitalização Infantil”, tendo como objetivo perceber a importância do lúdico no contexto da hospitalização infantil. Sendo assim, questionamos: até que ponto o lúdico pode influenciar as repercussões psicológicas emergentes da hospitalização infantil? Na tentativa de responder a esta questão traçamos algumas hipóteses que se seguem:  As atividades lúdicas contribuem para a diminuição das emoções negativas provenientes da hospitalização;  O tempo de internamento e a diminuição das emoções negativas estão unicamente ligadas as caraterísticas da doença e não à prática das atividades lúdicas;  O tempo de recuperação está pouco relacionado à prática de atividades lúdicas no ambiente hospitalar; A recolha dos dados, para a análise, processou-se mediante a observação das crianças hospitalizadas na pediatria do Hospital Regional Santiago Norte, Santa Rita Viera, elaborados em concordância com os objetivos que norteiam o presente estudo. Enfim, conseguimos perceber que o lúdico é uma atividade de extrema importância no processo da hospitalização, constituindo um bem para as crianças, bem como para os seus acompanhantes e os profissionais de saúde, uma vez que através dela, a criança adquire uma outra elaboração sobre os serviços hospitalares; terá uma melhora significativa do estado de humor, diminuindo os medos e as angústias, contribuindo melhor e mais ativamente para a sua melhoria.

Prevalence of left ventricular regional dysfunction in arrhythmogenic right ventricular dysplasia: a tagged MRI study.

BACKGROUND: Although arrhythmogenic right ventricular dysplasia (ARVD) predominantly affects the right ventricle (RV), genetic/molecular and histological changes are biventricular. Regional left ventricular (LV) function has not been systematically studied in ARVD. METHODS AND RESULTS: The study population included 21 patients with suspected ARVD who underwent evaluation with MRI including tagging. Eleven healthy volunteers served as control subjects. Peak systolic regional circumferential strain (Ecc, %) was calculated by harmonic phase from tagged MRI based on the 16-segment model. Patients who met ARVD Task Force criteria were classified as definite ARVD, whereas patients with a positive family history who had 1 additional minor criterion and patients without a family history with 1 major or 2 minor criteria were classified as probable ARVD. Of the 21 ARVD subjects, 11 had definite ARVD and 10 had probable ARVD. Compared with control subjects, probable ARVD patients had similar RV ejection fraction (58.9+/-6.2% versus 53.5+/-7.6%, P=0.20), but definite ARVD patients had significantly reduced RV ejection fraction (58.9+/-6.2% versus 45.2+/-6.0%, P=0.001). LV ejection fraction was similar in all 3 groups. Compared with control subjects, peak systolic Ecc was significantly less negative in 6 of 16 (37.5%) segments in definite ARVD and 3 of 16 segments (18.7%) in probable ARVD (all P<0.05). CONCLUSIONS: ARVD is associated with regional LV dysfunction, which appears to parallel degree of RV dysfunction. Further large studies are needed to validate this finding and to better define implications of subclinical segmental LV dysfunction.

Regional coronary endothelial function is closely related to local early coronary atherosclerosis in patients with mild coronary artery disease: pilot study.

BACKGROUND: Coronary endothelial function is abnormal in patients with established coronary artery disease and was recently shown by MRI to relate to the severity of luminal stenosis. Recent advances in MRI now allow the noninvasive assessment of both anatomic and functional (endothelial function) changes that previously required invasive studies. We tested the hypothesis that abnormal coronary endothelial function is related to measures of early atherosclerosis such as increased coronary wall thickness. METHODS AND RESULTS: Seventeen arteries in 14 healthy adults and 17 arteries in 14 patients with nonobstructive coronary artery disease were studied. To measure endothelial function, coronary MRI was performed before and during isometric handgrip exercise, an endothelial-dependent stressor, and changes in coronary cross-sectional area and flow were measured. Black blood imaging was performed to quantify coronary wall thickness and indices of arterial remodeling. The mean stress-induced change in cross-sectional area was significantly higher in healthy adults (13.5%±12.8%, mean±SD, n=17) than in those with mildly diseased arteries (-2.2%±6.8%, P<0.0001, n=17). Mean coronary wall thickness was lower in healthy subjects (0.9±0.2 mm) than in patients with coronary artery disease (1.4±0.3 mm, P<0.0001). In contrast to healthy subjects, stress-induced changes in cross-sectional area, a measure of coronary endothelial function, correlated inversely with coronary wall thickness in patients with coronary artery disease (r=-0.73, P=0.0008). CONCLUSIONS: There is an inverse relationship between coronary endothelial function and local coronary wall thickness in patients with coronary artery disease but not in healthy adults. These findings demonstrate that local endothelial-dependent functional changes are related to the extent of early anatomic atherosclerosis in mildly diseased arteries. This combined MRI approach enables the anatomic and functional investigation of early coronary disease.

Annual Report of the Iowa Grape and Wine Development Commission for Fiscal Year, 2007

FY2007 was a productive year for the Iowa Grape and Wine Development Commission. Fourteen proposals were recommended for funding totaling over $390,000 in outlays. Included in the approved proposals were funds for the establishment and staffing of a Midwest Grape and Wine Institute at Iowa State University, a newly created viticulturist position at Des Moines Area Community College, funding for the first annual Mid-American Wine Competition, and marketing and promotion of four regional cooperative wine events and one wine trail. Commission funding supported a survey of commercial wine producers and grape growers and a new brochure on Iowa’s vineyards. A committee was formed to provide details for a Scholarship Program to aid vineyard and winery staff with the expenses of accredited coursework. Based on the survey conducted and from other governmental and industry sources, the Iowa grape and wine industry appears to continue to be very viable and growth continues at a strong pace. Wine produced in the state for 2007 was estimated at a market value in excess of $12.3 million. A tabulation of the budget revealed that just over $800,000 in wine gallonage tax appropriations have been received into the Grape and Wine Development Fund from 15 FY2003 through FY2007. Expenditures have totaled just over $607,000 during that same time. Just over 80% of expenditures have gone to “Technical” spending. Over time, funds invested in “Technical” programs will translate into an increasingly educated and institutionally-supported industry. Local, regional, and statewide events also appear to be increasing in popularity and the Commission plans to continue and increase support for these events. It is hoped the Scholarship Program will be up and running and funding will need to be appropriated for that project. The Commission also believes many projects and events will become more and more self sustaining as they develop and mature. As they continue to support Iowa’s grape and wine industry, the members of the Commission look forward to working with individuals, commercial enterprises, state and federal agencies, and industry-sponsored institutions in the upcoming year and in years to come.

Annual Report of the Iowa Grape and Wine Development Commission for Fiscal Year, 2008

FY2008 was a productive year for the Iowa Grape and Wine Development Commission. Sixteen proposals were recommended for funding from FY2008 funds and carryover totaling just over $396,000 in outlays. Included in the approved proposals were staffing and equipment for the Midwest Grape and Wine Industry Institute’s wine diagnostics laboratory at Iowa State University, continued support for the viticulturist position at Des Moines Area Community College, funding for the second annual Mid-American Wine Competition, and assistance for marketing and promotion of Ice coats an Iowa vineyard after a February 2008 ice storm. Photo by Mike White and courtesy of Iowa State University. 16 two wine trail associations and seven festivals and events. Commission funding supported a salaried position within IDALS to manage the Iowa Grape and Wine Development Fund and to serve as the Director of the Iowa Grape and Wine Development Commission. The Commission approved funding for a Scholarship Program. The formally created Scholarship Committee met twice in FY2008 to finalize details for the Program and to approve scholarships to twenty-six applicants to aid with the expenses of accredited coursework. Based on data collected by IDALS, the Iowa Department of Economic Development, the Iowa Alcoholic Beverages Division, and Iowa State University the Iowa grape and wine industry appears to continue to be very viable and growth continues at a strong pace. Presently, Iowa ranks 14th in the nation for the number of wineries, and wine produced in the state for 2008 was estimated at a market value in excess of $14.0 million. A tabulation of the budget revealed that just over $1,080,000 in wine gallonage tax appropriations and legislative appropriations have been deposited into the Grape and Wine Development Fund from FY2003 through FY2008. Removing encumbered funds, expenditures have totaled just over $942,500 during that same time. “Financial” funding – used for fostering public awareness and participation of industry events - increased from 6% of expenditures in FY2007 to 9% in FY2008. Used for support of research, education, and outreach, a little over 80% of expenditures and encumbered funds were earmarked for “Technical” spending. Over time, funds invested in “Technical” programs will translate into an increasingly educated and institutionally-supported industry. Local, regional, and statewide events also appeared to be increasing in popularity. The Commission was encouraged to see increased support for these events. It is hoped, too, that the Scholarship Program will provide needed funding to help meet the educational goals of the industry’s workforce. As they continue to support Iowa’s grape and wine industry, the Commissioners look forward to working with individuals, commercial enterprises, state and federal agencies, and industry-sponsored institutions in FY2009 and in years to come.

Combined report on the institutions under the control of the Iowa Department of Human Services for the year ended June 30, 2008

Combined report on the institutions under the control of the Iowa Department of Human Services for the year ended June 30, 2008

Combined report on the institutions under the control of the Iowa Department of Corrections for the year ended June 30, 2008

Combined report on the institutions under the control of the Iowa Department of Corrections for the year ended June 30, 2008

Report of the Section of Agencies and Institutions Division of Child Welfare State Department of Social Welfare, 1943

History of child and social welfare in the State of Iowa including legal responsibilities, rules and regulations, inspections and licensing and supervision. it also covers cooperation with state agencies. It also describes in detail the histories, functions and problems of individual welfare homes and schools.

Incidents occuring during anesthesia for total hip arthroplasty: a comparison of general versus regional anaesthesia

Background: The type of anesthesia to be used for total hip arthroplasty (THA) is still a matter of debate. We compared the occurrence of per- and post-anesthesia incidents in patients receiving either general (GA) or regional anesthesia (RA). Methods: We used data from 29 hospitals, routinely collected in the Anaesthesia Databank Switzerland register between January 2001 and December 2003. We used multi-level logistic regression models. Results: There were more per- and post-anesthesia incidents under GA compared to RA (35.1% vs 32.7 %, n = 3191, and 23.1% vs 19.4%, n = 3258, respectively). In multi-level logistic regression analysis, RA was significantly associated with a lower incidence of per-anesthetic problems, especially hypertension, compared with GA. During the post-anesthetic period, RA was also less associated with pain. Conversely, RA was more associated with post-anesthetic hypotension, especially for epidural technique. In addition, age and ASA were more associated with incidents under GA compared to RA. Men were more associated with per-anesthetic problems under RA compared to GA. Whereas increased age (>67), gender (male), and ASA were linked with the choice of RA, we noticed that this choice depended also on hospital practices after we adjusted for the other variables. Conclusions: Compared to RA, GA was associated with an increased proportion of per- and post-anesthesia incidents. Although this study is only observational, it is rooted in daily practice. Whereas RA might be routinely proposed, GA might be indicated because of contraindications to RA, patients' preferences or other surgical or anaesthesiology related reasons. Finally, the choice of a type of anesthesia seems to depend on local practices that may differ between hospitals.

Status Report Midwest Regional Rail Passenger Initiative and Passenger Rail Service in Iowa February 1, 2010

This report fulfills the requirements of the following Code of Iowa sections: Section 327J.3(1): “The director may expend moneys from the fund to pay the costs associated with the initiation, operation, and maintenance of rail passenger service. The director shall report by February 1 of each year to the legislative services agency concerning the status of the fund including anticipated expenditures for the following fiscal year.” Section 327J.3(5): "The director shall report annually to the general assembly concerning the development and operation of the midwest regional rail system and the state's passenger rail service."

Audit report on the South Central Iowa Regional E-911 Service Board for the year ended June 30, 2009

Audit report on the South Central Iowa Regional E-911 Service Board for the year ended June 30, 2009

Audit report on the Heart of Iowa Regional Transit Agency, Des Moines, for the year ended June 30, 2009

Audit report on the Heart of Iowa Regional Transit Agency, Des Moines, for the year ended June 30, 2009

Audit report on the Great River Regional Waste Authority for the year ended June 30, 2009

Audit report on the Great River Regional Waste Authority for the year ended June 30, 2009